Provider Demographics
NPI:1003456799
Name:PRAY, BEVERLY (OTR)
Entity Type:Individual
Prefix:MS
First Name:BEVERLY
Middle Name:
Last Name:PRAY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4327 N CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-1326
Mailing Address - Country:US
Mailing Address - Phone:509-263-1408
Mailing Address - Fax:
Practice Address - Street 1:1906 FAIRVIEW AVE STE 330
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5425
Practice Address - Country:US
Practice Address - Phone:208-385-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics